Lordosis: What Is an Excess Lower-Back Curve and How Do You Know You Have One?
Lordosis is the natural inward curve of your lower back. When that curve becomes exaggerated, often called hyperlordosis, your pelvis tips forward and your lower back carries extra load. A standing whole-body scan can measure the curve while you bear your own weight. This shows alignment problems that scans done lying down can miss.
Key points
- Some lordosis is normal. It only becomes a problem when the curve is excessive and causes pain or stiffness.
- Hyperlordosis often starts with a pelvic tilt, tight hip flexors or weak core muscles.
- Scans done lying down relax the spine and can hide the true size of the curve.
- A standing EOS scan captures your full alignment from head to feet under gravity.
- ScanAlign provides the imaging. Treatment decisions are made with your clinician.
Your lower back is meant to curve inward a little. That curve helps absorb shock when you walk. It also keeps your weight balanced over your hips. The trouble starts when the curve deepens beyond what is healthy. Your belly pushes forward, your buttocks stick out, and your lower back muscles tighten to make up for it. Over time this can lead to persistent pain, stiffness and problems elsewhere in the body.
What are the symptoms of lordosis?
The most common symptom of excessive lordosis is a tight, aching lower back that gets worse after standing or walking for a long time. But the effects often spread well beyond the lower back itself.
A deep ache across the base of the spine, worse after long periods of standing or walking.
Your belly seems to push forward and your buttocks stick out clearly behind you.
Difficulty bending forward or straightening up fully, especially first thing in the morning.
Hip pain, knee discomfort or upper back tension that seems unrelated but comes from the same misalignment.
Your body is a connected chain from feet to head. So an exaggerated lower-back curve can force your mid-back, hips and knees to compensate. That is why pain often shows up away from the actual problem.
When to get urgent help. If you notice numbness or weakness in your legs, or any loss of bladder or bowel control, contact your doctor or go to the nearest emergency department straight away. These signs need immediate medical attention, not a routine scan.
What causes lordosis to become excessive?
Hyperlordosis develops when the muscles and structures around the pelvis and lower spine fall out of balance. Several things can tip that balance.
Hours in a chair shorten the hip flexors and weaken the glutes, pulling the pelvis forward.
When the stomach muscles cannot support the spine, the lower back arches too much to compensate.
Carrying extra weight around the stomach shifts your centre of gravity and increases the curve.
Spondylolisthesis (a vertebra slipping forward), disc problems or past spinal surgery can change the curve.
Lordosis is not the same as kyphosis. Kyphosis is an excessive outward rounding of the upper back. The two conditions can exist together, with the lower back arching too much to balance a rounded upper back.
Why should lordosis be checked while standing?
Your spinal curves change shape depending on whether you are standing or lying down. When you lie on a scanner bed for a standard X-ray, CT or MRI, gravity is removed and your muscles relax. The curve can then flatten or shift. The image may look normal even when your lordosis is excessive in everyday life.
An EOS scan takes a full-length image of your skeleton while you stand naturally, bearing your own weight. It captures your spine, pelvis, hips and legs in one single exposure, using about 90% less radiation than a standard X-ray, around ten times less. This means your clinician can see exactly how your lower-back curve behaves in real life, and how it relates to the position of your pelvis, hips and legs.
Want to understand your lower-back curve in full standing alignment? A free video consultation can tell you whether an EOS scan in London is the right next step before you plan your trip.
Book a free video consultationWhen MRI is the better choice. EOS shows bones, joints and alignment clearly. If your clinician suspects disc problems, nerve compression or other soft-tissue issues, MRI is usually the better tool. The two scans work well together.
How is lordosis managed?
Management depends on what is causing the excessive curve and how much it affects your daily life. The first step is always an accurate assessment, so any treatment plan is based on real findings, not guesswork.
Common approaches include physiotherapy to strengthen weak muscles and stretch tight ones, posture retraining, and in some cases orthotics or manual therapy. If a structural problem such as spondylolisthesis is involved, a surgeon may need to assess you further.
ScanAlign does not provide treatment. It provides detailed standing imaging that helps your treating clinician understand your alignment from head to feet and plan around it. You can take your scan results back home to any specialist you choose.
Before you start treatment, or change the one you are on, it is worth getting a detailed diagnosis. Knowing whether the cause sits in your pelvis, your legs or your spine changes what will actually help.
To learn more about how alignment imaging works for the whole spine, visit the spine imaging page.
Frequently asked questions about lordosis
Yes. A gentle inward curve in the lower back is completely normal and helps your spine absorb shock. It only becomes a concern when the curve is significantly exaggerated and causes pain or affects how you move.
Lordosis is an inward curve of the lower back. Kyphosis is an outward curve of the upper back. Both are normal in moderation. When either becomes excessive, it can cause pain and posture problems. The two can occur together.
Many cases of hyperlordosis improve with targeted physiotherapy, stretching and changes in posture. Whether this is enough depends on the cause. Accurate imaging helps your clinician decide the best approach for you.
When you lie flat, gravity no longer acts on your spine and your muscles relax. This can reduce the curve and make it look less significant than it really is when you are standing and bearing weight.
An EOS scan is a low-dose, standing X-ray that captures your entire skeleton from head to feet in one image. It uses about 90% less radiation than a standard X-ray, around ten times less. For lordosis, it shows the true curve while you bear weight and how it relates to your pelvis, hips and legs.
No. ScanAlign is a private, self-pay clinic. You can refer yourself. The process starts with a free video consultation to check whether an EOS scan is the right step for you.
Yes. The EOS system uses about 90% less radiation than a standard X-ray, around ten times less. You can find more detail on safety on the FAQs page.
The price for patients travelling from abroad is confirmed during the free video consultation. You can find more on the FAQs page.
Yes. Tight hip flexors pull the front of the pelvis downward, tilting it forward and increasing the lower-back curve. This is one of the most common contributors to hyperlordosis, especially in people who sit for long periods.
You speak briefly with a member of the ScanAlign team about your symptoms and history. They explain whether an EOS scan is suitable for you. There is no obligation and no charge.
Understand your lower-back curve, standing up
A free video consultation is the first step. No referral needed, no obligation.
Book a free video consultationSources
- NHS, "Back pain," nhs.uk, 2023.
- Been, E. and Kalichman, L., "Lumbar lordosis," The Spine Journal, 14(1), 87-97, 2014.
- Illés, T. et al., "The EOS imaging system and its uses in daily orthopaedic practice," International Orthopaedics, 36(7), 1325-1331, 2012.
Written by Abbas Dhami (Specialist Diagnostic Radiographer)
This page is general information and not a diagnosis.
ScanAlign is the trading name of CoreMed Solutions Ltd and operates under The Harley Street Hospital's CQC licence.